Dermatology dentally relevant questions Flashcards
What type of allergic reaction occurs to natural rubber latex?
Type 1 hypersensitivity (immediate - in minutes)
Contact urticaria and anaphylaxis
What dental materials can cause contact dermatitis?
Nickel
Epoxy resin
Dental acrylates –> dentures and composites
What type of reaction can occur between the oral mucosa and amalgam?
Oral lichenoid reaction
What is the process that drives lichen planus to occur?
T-lymphocyte driven chronic autoimmune disease
Multifactorial aetiology - drug induced, amalgam or unidentifiable
What does the skin, mucosa and genitals look like with lichen planus?
Skin - papular, purple, itchy lesions on flexor of forearm and shins
Mucosa - white reticulate pattern of keratosis on >1 mucosal surface, plaque like keratosis, desquamative gingivitis
Genitals - reticular keratosis, erythema, ulceration
What treatment is given for lichen planus?
Topical/systemic immunosuppressants
No satisfactory treatment
What do the mucosal lesions, systemic symptoms and discoid (Skin) symptoms of lupus erythematous look like?
Mucosa - Look like OLP –> White reticulate pattern of keratosis, plaque like keratosis
Systemic - Butterfly like risk across checks
Discoid - Skin lesions/plaques on head and neck, causing severe scars and permanent pigment change
What drugs and virus’ can cause erythema multiforme?
Sulfonamides and anticonvulsants (phenytoin and carbmazepine)
HSV and mycoplasma pneumonia
What treatment is given for erythema multiforme?
Antiviral
Drug cession
Topical steroid
What are the intraoral signs of pemphigus vulgaris?
Epidermis is breaking down causing mucosal erosion, ulceration, blistering
Nikolsky’s sign –> Desquamative gingivitis and pressure =blister
What treatment is given for pemphigus vulgaris?
For mild - topical steroids/orbase
For severe - multi-disciplinary
What oral signs are seen in mucous membrane pemphigoid? and what treatment is given for this disease?
Mucosal erosion, SP/HP ulceration, desquamative gingivitis, scarring
For mild - topical steroids
For severe - multi-disciplinary
What is BCC? and whats its growth?
Carcinoma in the basal cell layer of epidermis
Most common skin cancer
Slow growth, local and lesions don’t metastasise
What are the clinical features of BCC?
Pearly Telangiectasia Ulcerated Pigmented Common in the head and neck area
What treatment is provided for BCC?
Excision
Mohs micrographic surgery - high risk lesions
Cautery - low risk/small lesions
Cryotherapy - superficial BCC
Non-surgical: topical, radiotherapy, VISMODEGIB (oral drug inhibiting hedgehog signally pathway, which drives BCC)
What is SCC?
Malignant tumour of skin keratinocytes, growing more rapidly than BCC
What are the clinical features of SCC?
Hyperkeratotic
Sometimes ulcerated and painful
Not pearly/telangiectasia
What is the treatment provided for SCC?
Excision Cautery Cryotherapy LN dissection Adjuvant radiotherapy Chemotherapy Immunotherapy
What are the ABCDEs of malignant melanoma?
Asymmetry - whereas moles are symmetrical
Border irregularity - whereas moles smooth and even
Colour variation - usually 3+ colours, whereas moles have 1-2 colours (red/brown)
Diameter - >6mm
Evolving - constant unstable change
What is the treatment provided for malignant melanoma?
Complicated and aggressive and high mortality Surgery - most common LN dissection - stage 3 Immunotherapy - stage 4 Targeted drug treatment Radio and chemo - rare for cure
What does pigment depend on?
No. of melanocytes and amount of melanin they produce
What causes internal pigmentation?
Race Addison's disease ACTH-producing hormones Pregnancy pigmentation Drug induced = anti-malarial's
What oral manifestation occurs with intake of nicrorandil?
(K channel activator)
Oral/skin ulcers
Managed by decreasing dose
What oral manifestation occurs with intake of oxybutynin?
Lichenoid skin reaction, hard to distinguish from OLP
What oral manifestation occurs with intake of captopril?
(ACEI)
May induce pemphigus vulgaris
What dental materials may cause burning mouth syndrome?
Mainly metals, activators, methacrylates
